**Background:** Europe's aging population is increasing demand for health and social services, particularly for older adults with multimorbidity who face higher risks of adverse outcomes. Frailty—a syndrome of reduced physiological reserve leading to increased risk of falls, hospitalization, disability, and death—is potentially reversible if detected early. The SUNFRAIL project previously developed a 9-item tool for early frailty identification in community settings. The SUNFRAIL+ study extends this by creating a digital platform that links each SUNFRAIL item to validated in-depth assessment scales, enabling comprehensive bio-psycho-social evaluation. The family and community nurse (FCN) is positioned as the first point of contact in this model, coordinating with specialists as needed.
**Methods:** This is a prospective observational cohort study conducted across seven centers in seven Italian regions: Campania (coordinator, University of Naples Federico II), Liguria (Azienda Sociosanitaria Ligure 4), Autonomous Province of Trento (Azienda Provinciale per i Servizi Sanitari), Calabria (Res Omnia Social Cooperative), Piedmont (Azienda Sanitaria Locale Cuneo 1), Tuscany (Azienda Unità Sanitaria Locale Nord-Ovest), and Lazio (University of Rome Tor Vergata). Each center will recruit 100 ambisexual, randomly selected community-dwelling older adults (total N=700). Inclusion criteria: age ≥65 years, living at home, accessing centers for unrelated services, able to consent. Exclusion criteria: age <65, care facility residents, overt frailty or disability, already enrolled in home care, unable to understand study aims. The study runs 14 months: 6 months enrolment (first multidimensional assessment), 6 months observation (taking charge with health promotion activities), and 2 months follow-up (data analysis). During enrolment, the SUNFRAIL tool is administered; based on responses, participants receive one or more validated in-depth scales from the SUNFRAIL+ platform. Instruments include: SUNFRAIL (frailty screening), MARS (medication adherence), PREDIMED and MNA (nutrition), SPPB (physical activity), AFEAT and Timed Up and Go (fall risk), QMCI and GPCOG (cognitive decline), GDS (loneliness/depression), SPS (social support), MUSE (socioeconomic conditions), SF-12 (quality of life), and SUS (system usability). During observation, healthy older adults receive collective physical exercise, nutritional recommendations, socialization services, and fall prevention education. Those with chronic diseases additionally receive patient empowerment and adherence support. At 6-month follow-up, all instruments are re-administered, and healthcare utilization, quality of life changes, and professional satisfaction are measured. Statistical analysis includes descriptive (frequency distributions, means, medians, standard deviations) and confirmatory analyses (chi-square, McNemar, paired t-test, Wilcoxon, multiple linear regression with SF-12 as dependent variable). All tests are two-sided at 5% significance. With 80% power, 5% type I error, 95% confidence, targeting 10% SF-12 improvement, minimum sample size is 195; the 700-participant enrolment allows nested analyses. Analyses use IBM SPSS Statistics v26.
**Clinical Implications:** If successful, SUNFRAIL+ will provide a validated, digitally supported, multiprofessional service model for early frailty screening in community-dwelling older adults. The platform addresses fragmentation of care by integrating general practitioners, geriatricians, territorial specialists, rehabilitators, and family and community nurses. By linking screening directly to targeted interventions (physical activity, nutrition, fall prevention, cognitive support, socialization), the model aims to prevent progression from frailty to disability and dependency. The approach is designed for deployment across diverse settings and levels of care, not limited to dedicated healthcare facilities. The study's main limitation is non-uniformity of intervention strategies and available services across participating centers, which limits ability to investigate effectiveness of specific prevention interventions. Outcomes depend on each center's capacity to link screening results with locally available prevention and health promotion services.